Health Law and Ethics: Vaccination Policies for Influenza in Victoria

This essay delves into the critical issue of influenza vaccination within the Victorian community, examining its ethical and legal implications. It begins by defining the influenza epidemic and its impact on the population, particularly vulnerable groups like children and the elderly. The essay highlights the importance of vaccination in mitigating the spread of the flu and its ethical impact on public health, including the principles of autonomy, beneficence, justice, and non-maleficence. It analyzes current healthcare policies, such as the National Immunization Program and the Australian Immunisation Register Act, while also acknowledging their limitations, such as the lack of mandatory vaccination. The essay incorporates argumentation to address public perceptions and the need for increased awareness regarding vaccination benefits. It concludes by emphasizing the responsibility of healthcare authorities to educate the community and promote participation in vaccination programs to reduce the incidence of influenza and protect the ethical rights of all individuals. The essay also explores the role of ethical principles in mandatory vaccination policies and the need for a comprehensive approach to address the challenges posed by influenza outbreaks.

Running Head: HEALTH LAW AND ETHICS
HEALTH LAW AND ETHICS
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Introduction:
An influenza epidemic or flu epidemic is described as the worldwide spread or infection
of the flu. It affects a significant part of the demographic population. Influenza flu in
Victoria is common and occurs around every year affecting a large number of
communities. The substantial population affected by the flu is the children,
older adults, and aged care residents. According to Victoria State Government
(2019), in the year 2019, around 76 deaths have been observed due to the
epidemic, among which the highest number of individual are the children.
The demise includes around 61 older individuals of the aged care residents,
five children, and ten older adults. The figures in increasing every year
making it a significant health concern for the population of Australia. In the
year 2019, the total number population observed to be affected by the flu is
around 36,440 which are approximately 12 times the last year. In July, the
whole numbers of influenza flu recorded are 2851 which had been increased
to 5052 in the year 2017. According to the Victoria State Government (2019), in
the year 2019, the onset of flu has been observed in the individual much
earlier as compared to the previous years. One of the primary reasons
behind the exceeding prevalence rate of influenza infection in the Victorian
population is the lack of awareness regarding vaccination. Hence by
analysing the prevalence and incidence data of the influenza flu among the
Victorian community, it can be stated that protection against flu among the
population is necessary as it hinders the ethical consideration of other

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patient such as, autonomy, beneficence, justice and non- maleficence. With
the aid of vaccination, the total prevalence and incidence rate of the
influenza infection is supposed to be reduced.
This discussion intends to focus on the importance of vaccination
among the Victorian population to reduce the impact of epidemic flu and is
ethical impact on the public. The study includes the critical analysis of the
healthcare policies and principles for such epidemics along with their
strength and limitation. Argumentation is also incorporated in the discussion
which aims to logical and clear arguments along with recommendation which
is evidence-based.
Critical analysis:
Influenza is commonly termed as flu which is caused by the influenza
virus. It is an infectious disease and hence can be transmitted from infected
individual to the healthy individual via different means, which can be
considered as one of the principal cause behind the flu epidemic (Yao et al.
2019). There is no proper treatment which can completely eradicate the signs
and symptoms of influenza; hence, the only way to get rid of the flu is to
apply the prevention strategy. Vaccination of flu has been proved to provide
effective prevention against flu in future. Vaccination aims to protect against
the strains that are responsible for causing flu. According to Littauer et al.
(2018), vaccination against influenza is one of the most effective methods to
diminish the rate of flu among the public.

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The outbreak of influenza among the Victorian population is observed almost every year,
and due to the lack of immunization, it spreads from one individual to another within a short
period creating an epidemic (Price et al. 2019). It has been observed to hinder the ethical rights
of the patient. Only the patient living in the big cities are getting the privilege of the primary
medical service. According to the ethical principle, justice, the healthcare resources should be
equally distributed among the all the public to enhance the health outcome of the public.
However, in this case, the Victorian population are not able to access the vaccination services.
It also violates other ethical rights of the patient that is Beneficence and non- maleficence.
As according to beneficence, the health practitioner should act to provide best service for
improved health which is violated in the case of Victorian population. As the population are not
much aware about the vaccination, they cannot take appropriate health related decision on their
own which disrupts the autonomy of the patient. This prevalence rate of the flu endemic is
getting increased day by day. To reduce the rate of influenza flu among the Victorian population
Australia has a National Immunization Program (1997), under which all the individual should be
vaccinated once in a year to avoid any harm posed by flu on public health. This program
involves different health professionals, who assess the health of the patient and deliver
immunization (Baxter, Clothier and Perrett 2018). Those who are eligible for vaccination can get
the access of the immunity services, which is Flu immunization service (2019) has been
formulated by the Australian government. Under this program, all the individuals who are at the
higher risk of getting affected with influenza such as, the indigenous populations of Australia,
pregnant women, older adults, new borne should be vaccinated (Grant et al. 2017). Under this
program, the public of the Victoria can get the vaccination at free of cost or low cost. Another
law, Australian Immunisation Register Act 2015 has also been formulated the government to

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keep track of the individuals who are eligible for vaccination or has been vaccinated previously.
This law maintains the privacy of the patient and abides by the ethical principle of the patient.
According to Federal Register of Legislation (2019), Immunization program of the Australia
Capital Territory (ACT) 2015 provides the list of vaccination. In the list, the vaccination is
characterized according to the age or risk group and disease. It allows the population to get
information about several vaccinations and make decision accordingly, which protects patient’s
autonomy.
One of the primary advantages of such program is that it provides vaccination against flu
and also creates awareness regarding the adverse impact of flu, but it is not compulsory for the
entire population which can be considered as its limitations. Due to which, only the minor
population of the community, who are aware of the importance of influenza vaccination get
vaccinated, but still the majority of the people remain unimmunized against the influenza virus
and hence their ethical rights are not considered. The frequent outbreak of the flu can only be
eradicated if the entire population is immunized against the virus. Instead of having different
vaccination program, the prevalence rate of the flu among the Victorian community is increasing
day by day. Rendering to the research conducted by Schwarze et al. (2018), the higher incidence
is of epidemic flu is due to the lack of awareness regarding the importance of vaccination and its
impact. According to them, vaccination does not provide 100% effective result against influenza.
They have a perception that the outbreak is due to the wrong season and hence cannot be
eradicated with the aid of the vaccination or immunization. Upon conducting a survey by Pebody
et al. (2016), it is observed that the majority of the population is aware of the fact that no
vaccination is 100% effective, and hence after that also they have to follow the protective
measure such as, maintaining hygiene, stay home, avoid coming in contact with the infected

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individuals and therefore the vaccination is not worth. As per their views, the outbreak of
influenza cannot be exterminated even after getting vaccinated.
According to Moss et al (2018), after observing the influenza epidemic in Victoria from
the last 4 years, the, Australian Health Management Plan for Pandemic Influenza, has developed
social and medical management plan, which aims to deal with the new strains of the virus such
as the influenza virus, which was expected to increase the death rate by 40%. Therefore to reduce
the mortality rate due to the outbreak of influenza and its new strain, a social and medical
management plan has been formulated by the government. In the social and medical
management plan, the populations of the Victoria are aware of the prevention strategy of the flu
which was expected to decrease the adverse impact of the influenza outbreak.
Though this strategy is found to be effective in reducing the mortality rate of the
influenza death but has a limitation associated with it that is, in the program the population are
only aware of the prevention strategy, but not about the vaccination, even though vaccine is more
effective than that of the other approach. Therefore, the influenza vaccination should be made
compulsory for all the community members of Australia (Moran, Agaliotis and Seale 2019).
By critically analysing the views and perception of the public of the Victoria, it has been
observed that they have lack of appropriate knowledge regarding the importance and benefits of
vaccination (Belongia et al. 2017). Therefore, it is the responsibility of the healthcare authorities
to educate them about the risk of flu on both mental and physical health. The community
members of Australia should also be trained about the advantages and effectiveness of
vaccination. By the aid of this, they will be more conscious about the outbreak of epidemic every

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year, and it will also enhance their participation in the National vaccination program and other
vaccination program developed by the government of Australia.
ARGUMENTATION
The outbreak of flu had reported to kill more than 37 Victorians that included hospital
workers and had also reported to affect the public of Victoria, hampering their life-style and
general activities of life. The outbreak of flu in Australia is highest among the winters and it is
very essential for the general public to get vaccinated from the influenza vaccine to prevent the
adverse health effect of flu. Influenza was initially reported to affect Australia in 1820 and since
then the number of affected population are increasing in Australia, which consists of pandemics
series in 1890, 1957, 1968 and 2009 (NewsComAu, 2019). According to Johnson et al. (2016), it
is globally accepted that vaccinating any individual with vaccine tend to reduce the health
complication and transmission of disease within the population. The ethical considerations of
influenza vaccine on the basis of public and clinical health perspective are used to examine if the
influenza vaccine can be made mandatory for the public or not. There are various factors that is
responsible for increasing the outbreak of flu such as lack of awareness and testing or due to
persistent illness affecting the population. The Health and Human Services of Australia had
highlighted the horror of flu had estimated to kill approximately 3400 people, which is double
than the standard rate of influenza cases. The influenza vaccination program should be
established and implemented by the government of Australia, which will aim to educate the
general population regarding the benefits of influenza vaccination (Keilman 2019). The four
ethical principles are considered before implementing the mandatory influenza vaccine, where
autonomy states that medically susceptible and capable patients will opt not to obtain a life-
frightening illness due to their compromised health. Based on the second principle, beneficence,

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will help the target group to address the advantage of mandatory vaccination and protect
themselves from the flu, whereas, non-maleficence, state that vaccine is implemented for their
own good and will not harm the target group by any mean and help them to avoid any fatal
health complication. With the aid of mandatory vaccination, whole population will get access to
vaccination which will protect the fourth ethical principle, justice. It is stated that the Victorian
population is extremely uncooperative with vaccination administrations and hence must be
educated regarding the vaccination international guidelines that will aim to increase the influenza
immunisation rate which will reduce the resistance towards influenza virus outbreak.
In Victoria, May and October is considered as the season of influenza, where the rate of
influenza flu is recorded highest and to mitigate the adverse effect the general population as well
as the health practitioners must get vaccinated, which will eventually aim to reduce the enhanced
risk of influenza. An antigenic analysis is performed in Victoria for the circulating influenza
viruses in 2019, which exhibited that the influenza A (H1N1) pdm09 and influenza B/Yamagata-
lineage viruses are considered as the supremely matched to the influenza vaccine circulated in
2019 (Lee, Phillips and Faix 2018). While there are also some other viruses such as A (H3N2)
and B/Victoria-lineage viruses which are less matched as compared to the other two viruses.
Based on the Australian Influenza Surveillance Report (AISR), the efficacy and effectiveness of
the influenza vaccine is explained that would focus on explaining the impact of the vaccine on
the general population. AISR focuses on increasing the awareness of the influenza activity by
delivering the surveillance data report in Victoria and other associated parts of Australia
(Department of Health, 2019). There are various methods that is adopted by the government of
Australia and implemented throughout Australia to increase the immunization rate which
includes education, easy access for the free vaccination, mandatory vaccination condition, active

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promotion and reminder notice. ABC News (2019) claims that the only solution to the high rate
of flu is government-mandate program towards vaccination and prevention, as this program will
increase the awareness of the general population and provide them appropriate direction towards
achieving a healthy life.
Whereas, it is also seen that there are few side-effects of vaccination that includes
swelling, pain and redness that inhibit the people to take vaccination as large number of people
are unaware regarding the short-term influence of this effect (Qualls et al. 2017). Hence, it is
very essential that the government of Australia enable the vaccination program abiding to the
ethical principles, as based on the ethical principle the implementation of mandate vaccination
will vary and following the national vaccination guidelines to educate and increase the awareness
of the general population and motivate the Victorian population to get vaccinated in order to
mitigate the adverse health complication of flu. Hence, it is evident that the government should
focus in increasing the awareness of the community members by educating them and conducting
the awareness campaign that would help them to understand the benefits or advantages of
vaccination. According to the Department of Health (2019), the Victorian government must
implement the government-mandatory vaccination program within the community, which will
state that it is mandatory to get influenza vaccine for all the members of the public during the flu
epidemic period in Victoria.
INVESTIGATION
A study was released by the researcher Grohskopf et al. (2019), who had focused in
stating the benefit of vaccination to fight against the outbreak of flu in the general population and
the community and had also stated the advancement towards the management of flu. The result

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of the research had exhibited that it was mandatory for the members of the public and within the
community setting to get vaccinated against the influenza and reduce the burden of disease in
Australia. The community members must be explained regarding the benefits of getting
vaccinated and thus would aim to enhance the positive health outcome. Principle-based method
is used to understand the ethical approach of the influenza vaccine on the basis of four primary
principles namely beneficence, autonomy, justice and non-maleficence. It was investigated that
the vaccine awareness program within the community will aid in improving the overall rate of
vaccination and also reduce the adverse health outcome of influenza (Demicheli et al. 2018). The
outcome will be more effective if the Victorian government implement free access towards
vaccination and also regulate the government-mandatory program that will in turn make the
vaccination program mandatory for every individual irrespective of their age or sex. The focus of
the vaccination program will be educate the community members regarding the advancement of
vaccination and what are the potential benefits of vaccination and also motivate them to conduct
vaccination campaigns or program in the community to educate the general population regarding
the vaccination and their potential advantages. Mandate vaccination will therefore help the
members of the public and the community members to successfully reduce the rate of flu by
getting vaccinated (Marshall et al. 2019).

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Reference:
ABC News (2019). 'No vaccine is 100 per cent effective': Flu outbreak kills 37 Victorians.
[online] ABC News. Available at: https://www.abc.net.au/news/2019-06-27/influenza-claims-
life-of-hospital-worker-in-eastern-victoria/11258022 [Accessed 24 Sep. 2019].
Baxter, C.M., Clothier, H.J. and Perrett, K.P., 2018. Potential immediate hypersensitivity
reactions following immunization in preschool aged children in Victoria, Australia. Human
vaccines & immunotherapeutics, 14(8), pp.2088-2092.
Belongia, E.A., Skowronski, D.M., McLean, H.Q., Chambers, C., Sundaram, M.E. and De
Serres, G., 2017. Repeated annual influenza vaccination and vaccine effectiveness: review of
evidence. Expert review of vaccines, 16(7), pp.723-736.
Demicheli, V., Jefferson, T., Ferroni, E., Rivetti, A. and Di Pietrantonj, C., 2018. Vaccines for
preventing influenza in healthy adults. Cochrane database of systematic reviews, (2).
Department of Health (2019). Department of Health | Australian Influenza Surveillance Report
and Activity Updates. [online] Www1.health.gov.au. Available at:
https://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-surveil-ozflu-flucurr.htm
[Accessed 24 Sep. 2019].
Grant, K.A., Carville, K.S., Sullivan, S.G., Strachan, J., Druce, J. and Fielding, J.E., 2018. A
severe 2017 influenza season dominated by influenza A (H3N2), Victoria, Australia. Western
Pacific Surveillance and Response, 9.

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Grohskopf, L.A., Alyanak, E., Broder, K.R., Walter, E.B., Fry, A.M. and Jernigan, D.B., 2019.
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory
Committee on Immunization Practices—United States, 2019–20 Influenza Season. MMWR
Recommendations and Reports, 68(3), p.1.
Federal Register of Legislation (2019). Australian Immunisation Register Act 2015. [online]
Legislation.gov.au. Available at: https://www.legislation.gov.au/Details/C2017C00258
[Accessed 26 Sep. 2019].
Johnson, S.A., Bennett, N., Bull, A.L., Richards, M.J. and Worth, L.J., 2016. Influenza
vaccination uptake among Victorian healthcare workers: evaluating the success of a statewide
program. Australian and New Zealand journal of public health, 40(3), pp.281-283.
Keilman, L.J., 2019. Seasonal Influenza (Flu). Nursing Clinics, 54(2), pp.227-243.
Lee, R.U., Phillips, C.J. and Faix, D.J., 2018. Seasonal Influenza Vaccine Impact on Pandemic
H1N1 Vaccine Efficacy. Clinical Infectious Diseases, 68(11), pp.1839-1846.
Littauer, E.Q., Mills, L.K., Brock, N., Esser, E.S., Romanyuk, A., Pulit-Penaloza, J.A.,
Vassilieva, E.V., Beaver, J.T., Antao, O., Krammer, F. and Compans, R.W., 2018. Stable
incorporation of GM-CSF into dissolvable microneedle patch improves skin vaccination against
influenza. Journal of controlled release, 276, pp.1-16.
Marshall, C., Williams, K., Matchett, E. and Hobbs, L., 2019. Sustained improvement in staff
influenza vaccination rates over six years without a mandatory policy. Infection Control &
Hospital Epidemiology, 40(3), pp.389-390.